Podcast 168 – Kyle Gunnerson and the EC3

A few years ago, I wrote an article about ED Intensivists and EDICUs. In the article, I discussed the hypothetical stand-alone EDICU. It is hypothetical no more. Kyle Gunnerson, with the support of his chair Bob Neumar, has created the EC3 at University of Michigan. Last week, I visited the unit–it was absolutely incredible! I invited Kyle to our RESUSCITATE NYC conference to discuss the great work he and his team have done.

I think Sam is referring to the Critical Care Resuscitation Unit at Shock Trauma. it was mentioned briefly in the Ask Us Anything session, someone referred to it as serving a purpose similar to an ED-ICU during the question regarding regionalization of critical care and national trends. I’m assuming Sam wants a comparison of the two, although it sounds like they share similar purposes.

Sam,
Good question. Like all traditional in-patient ICU’s we (EC3) have very similar elements of the care we deliver. The CCRU is an in-patient ICU designed to take primarily transfers from ICUs in outside hospitals. These patients have already been on ICU teams for a period of time. The CCRU provides a 24/7 place where these patients can be safely transferred and if further resuscitation/diagnostics are required urgently, they can be readily performed. After the “intake” plan as been implemented, then the patient can be safely transferred to the proper ICU or floor if needed.

The EC3 is in the ED and as such, is considered an outpatient area. We do not take transfers from other inpatient services at this time, however we do provide the same safe critical care landing zone for ED-ED critically ill transports. We also see patients very early in their disease presentation and critical illness trajectory as they present to the ED.

This is just a small sample of our similarities and differences. Both are very novel approaches in providing the best critical care in a timely fashion. Hope this helps.

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3 years ago

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Kevin Malone

I’m taking a health economics class and and I understand the idea of a ED-ICU and conceptually it sounds great. My question is, is this a cost effective intervention?

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3 years ago

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kgunner1

Good question Kevin. Not quite 1 year (we were fully operational April 1) is a little short to really appreciate the total economic impact. There are parts that are doing better than anticipated, and others that aren’t quite there yet. The devil’s in the details and we will start reviewing this with our finance people when we have a good representation. The last thing we want to do is make any premature decisions when the data is still developing.